Role Summary

HIGHLIGHTS

Manager-level Health rate setting role in Ohio Medicaid’s Managed Care Rate Setting (MCRS) team in Columbus, OH. You will develop and validate Medicaid capitation rates, liaise with MCOs and the State actuary, monitor MCO financial performance, and ensure CMS reporting and compliance. This role focuses on Medicaid capitation pricing and program financial administration.

JOB DESCRIPTION SUMMARY

Develop and administer Medicaid MMC capitation premium rates
Serve as liaison with seven MCOs and the State's actuary
Ensure CMS reporting compliance including rate certifications and MLR
Monitor MCO financial performance and healthcare expense data
Manage loading of capitation rates into the State payment system

DOMAIN EXPERTISE

HMO and hospital rate development
Health care data analysis
Health services contract management
Health services budget development
Health services program or project management

KEY REQUIREMENTS

Completion of a graduate core program in business/health/public administration OR 12 months relevant experience
Minimum 12 months experience in health services program delivery or project management
Experience with HMO and hospital rate development and health care financial analysis
Ability to manage multiple priorities and detailed compliance/reporting tasks

TECH STACK

No tech stack specified

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Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Develop and administer Medicaid MMC capitation premium rates
Serve as liaison with seven MCOs and the State's actuary
Ensure CMS reporting compliance including rate certifications and MLR
Monitor MCO financial performance and healthcare expense data
Manage loading of capitation rates into the State payment system

DOMAIN EXPERTISE

HMO and hospital rate development
Health care data analysis
Health services contract management
Health services budget development
Health services program or project management

KEY REQUIREMENTS

Completion of a graduate core program in business/health/public administration OR 12 months relevant experience
Minimum 12 months experience in health services program delivery or project management
Experience with HMO and hospital rate development and health care financial analysis
Ability to manage multiple priorities and detailed compliance/reporting tasks

TECH STACK

No tech stack specified

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Develop and administer Medicaid MMC capitation premium rates
Serve as liaison with seven MCOs and the State's actuary
Ensure CMS reporting compliance including rate certifications and MLR
Monitor MCO financial performance and healthcare expense data
Manage loading of capitation rates into the State payment system

DOMAIN EXPERTISE

HMO and hospital rate development
Health care data analysis
Health services contract management
Health services budget development
Health services program or project management

KEY REQUIREMENTS

Completion of a graduate core program in business/health/public administration OR 12 months relevant experience
Minimum 12 months experience in health services program delivery or project management
Experience with HMO and hospital rate development and health care financial analysis
Ability to manage multiple priorities and detailed compliance/reporting tasks